• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.428-436
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• 2008

For Longevity of implant, considerations of biomechanical and microbiological aspects must be done. Recently, due to the remarkable development of bone grafting procedure. Implant has been implanted into the more favorable sites but peri-implantitis resulted from periodontal bacteria may obscure the long-term prognosis. Although many different modalities have been introduced to treat the failed implant. Implant's surface and irreversible bony destruction around the implant prevents good result. After Er,Cr:YSGG (waterlase) laser using the wave-length of 2780nm has been introduced to dental field, good results have been reported. Because waterlase uses the hydrokinetic force of water. It is excellent device to detoxify the implant surface mechanically without the heat generation and damage to the implant surface. We designed to evaluate waterlase effect on the peri-implantitis has been occurred after implantation. Four beagle dogs were involved. We have made four premolar extraction in each right and left side of the lower jaw and placed two implants in the anterior of the jaw as a control and six implant were placed posterior in each socket after extraction immediately as an experimental group. We tied floss-silk in each implant to make peri-implantitis intentionally. After three months, we explored peri-implant sites on each experimental fixtures. Using waterlase laser irradiation was performed on that implantitis sites under 3W, air 30% and water 20% intensity for 2 minutes. In control group, we repositioned the flap to cover the exposed fixture without any supportive care. Three months later, we sacrificed experimental animals and extracted and preparated bone blocks with Donath and Breuner (982), Donath (988)'s methods and examined under microscope. We have obtained good re-osseointegration around fixtures after treating with waterlaser irradiation. But it was shown fibroosseointegration in the control group.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.2
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• pp.254-261
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• 2000

Since callus distraction technique was applied clinically for the correction of dentofacial deformity to the patients with hemifacial dysplasia by McCarthy in 1992, many surgeons have tried to apply this method to the maxillofacial region. But this technique has some drawbacks. One of the disadvantages of this technique is extensive scar formation in the facial area, which is a sequelae of extraoral approach for supraperiosteal dissection of the periosteum overlying the mandible. Recently, we have made an effort to perform this technique through intraoral approaches to prevent scar formation on the submandibular area and modified the design of the osteotomy, that is step osteotomy technique, to increase the raw bone surface on both osteotomized segments. The rationale for the application of this step osteotomy technique is to increase the amount of regenerated bone and the length of distraction, to avoid damage of inferior alveolar neurovascular bundle, and to increase initial stability of the splitted segments. Step osteotomy procedure can be done with fine micro-osteotomy saw through subperiosteal tunneling. Extraoral pins should be inserted before making the osteotomy. Since 1994 we have applied this technique at 8 sites In 5 patients with mandibular deficiencies: 2 cases of hemifacial microsomia, 1 case of developmental facial asymmetry and 2 cases of mandibular bony defect. Mandibular elongation have been achieved from 12 to 20mm in length. 1 out of 8 site, we experienced non-union in the case of mandibular body defect. Some skeletal relapse and growth retardation phenomenon have been observed in some cases with the longest follow-up of 48 months.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.282-288
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• 2010

Surgery with the computer navigation system can make it possible to identify important anatomical structures which are difficult to be confirmed with the naked eye in the operation, and has extended their applications in various surgical fields. The head and neck surgery especially requires detailed anatomical knowledges and these knowledges have influences on postoperative functions and esthetics of a patient. In the orthognathic surgery, we should take osteotomies in the precise locations of the jawbones and move segments to the intended positions. There are so many important anatomical structures around the osteotomy-sites in the orthognathic surgery that the prevention of damage to these structures to obtain satisfactory results without any complication. There are vessels of the pterygoid plexus posterior to the pterygoid plate in the maxilla and the mandibular nerve enters the mandibluar foramen in the mandibular ramus. These locations should be confirmed perioperatively to avoid any injury to these structures. The navigation-assisted surgery may be helpful for this purpose. We performed navigational orthognathic surgeries with preoperative CT images and obtained satisfactory results. The osteotomy was performed in the proper location and damaging the surrounding important anatomical structures was avoided by keeping the saw away from them with the real-time navigation. It may be required to develop proper devices and protocols for the navigation-assisted orthognathic surgery.

• The Korean Society of Law and Medicine
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• v.13 no.2
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• pp.309-334
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• 2012

Although the number of foreign patients visiting Korea for medical treatments or plastic surgery is rapidly increasing, countermeasures against unforeseen medical disputes involving foreign patients are adequate. To date, the record shows that most foreign patients have visited doctors at the departments of family medicine, internal medicine, dermatology (incl. plastic surgery), and healthcare centers, which, fortunately, indicates that there are not many severe, high risk patients. However, if the current growth rate continues to rise and the number of foreign patients visiting each department continues to grow, more diverse medical practices will be likely to take place in the future, and consequently, it is expected that the possibilities of medical malpractice and the costs of dispute resolution will also rise dramatically. When a medical dispute occurs, in general, a lawsuit is ultimately settled by the court. However, since this can damage the creditworthiness of medical institutions and also incur significant litigation costs, which is a typical characteristic of a medical lawsuit, medical professionals or institutions will be heavily burdened. Furthermore, an adequate policy or countermeasure against a medical dispute with a foreign patient has not yet been established, and it would be difficult to resolve a dispute by finding the middle ground, due to relative standards and policies between countries. Now, we need to improve the existing policies and prepare for countermeasures that will allow us to precisely predict the nature of such disputes, which have been increasing, and resolve them peacefully. Based on such knowledge, this study aims to establish countermeasures against medical disputes with foreign patients, and examine ways to promptly and reasonably resolve them at an early stage.

• Journal of Mechanical Science and Technology
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• v.20 no.7
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• pp.1002-1011
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• 2006

In this study, we describe the conventional hot pressing (CHP) of layered $Al-B_4C$ composites and their characterization. The matrix alloy Al-5 wt.%Cu was prepared from elemental powder mixtures. The metal and B4C powders were mixed to produce either $Al-Cu-10vol.%B_4C$ or $Al-Cu-30vol.%B_4C$ combinations. Then, these powder mixtures were stacked as layers in the hot pressing die to form a two-layered composite. Hot pressing was carried out under nitrogen atmosphere to produce $30\times40\times5mm$ specimens. Microstructural features and age hardening characteristics of composites were determined by specimens cut longitudinally. The flexural strength of both layered composites and their monolithic counterparts were investigated via three point bending tests. In the case of layered specimens of both $10vol.%B_4C$ and $30vol.%B_4C$ containing layers were loaded for three-point test. The results show that a homogeneous distribution of $B_4C$ particles in the matrix alloy which is free of pores, can be obtained by CHP method. The ageing behavior of the composites was found to be influenced by the reinforced materials, i.e. higher hardness values were reached in 8 hrs for the composites than that for the matrix alloy. Flexural strength test showed that two-layered composites exhibited improved damage tolerance depending on layer arrangement. Microstructural investigation of the fracture surfaces of the bending specimens was performed by means of scanning electron microscope (SEM). While layer with lower reinforcement content exhibited large plastic deformation under loading, the other with higher reinforcement content exhibited less plastic deformation.

• Steel and Composite Structures
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• v.35 no.3
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• pp.439-447
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• 2020

This paper presents two sets of full three-dimensional thermoelastic finite element analyses of superimposed thermo-mechanically loaded Spar Wingskin Joints made with laminated Graphite Fiber Reinforced Plastic composites. The study emphasizes the influence of residual thermal stresses and material anisotropy on the inter-laminar delamination behavior of the joint structure. The delamination has been pre-embedded at the most likely location, i.e., in resin layer between the top and next ply of the fiber reinforced plastic laminated wingskin and near the spar overlap end. Multi-Point Constraint finite elements have been made use of at the vicinity of the delamination fronts. This helps in simulating the growth of the embedded delamination at both ends. The inter-laminar thermoelastic peel and shear stresses responsible for causing delamination damage due to a combined thermal and a static loading have been evaluated. Strain energy release rate components corresponding to the Mode I (opening), Mode II (sliding) and Mode III (tearing) of delamination are determined using the principle of Virtual Crack Closure Technique. These are seen to be different and non-self-similar at the two fronts of the embedded delamination. Residual stresses developed due to the thermoelastic anisotropy of the laminae are found to strongly influence the delamination onset and propagation characteristics, which have been reflected by the asymmetries in the nature of energy release rate plots and their significant variation along the delamination front.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.25.1-25.9
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• 2015

Background: During the orthognathic surgery, it is important to know the exact anatomical location of the mandibular foramen to achieve successful anesthesia of inferior alveolar nerve and to prevent damage to the nerves and vessels supplying the mandible. Methods: Cone-beam computed tomography (CBCT) was used to determine the location of the mandibular foramen in 100 patients: 30 patients with normal occlusion (13 men, 17 women), 40 patients with skeletal class II malocclusion (15 men, 25 women), 30 patients with skeletal class III malocclusion (17 men, 13 women). Results: The distance from the anterior border of the mandibular ramus to mandibular foramen did not differ significantly among the three groups, but in the group with skeletal class III malocclusion, this distance was an average of $1.43{\pm}1.95mm$ longer in the men than in the women (p < 0.05). In the skeletal class III malocclusion group, the mandibular foramen was higher than in the other two groups and was an average of $1.85{\pm}3.23mm$ higher in the men than in the women for all three groups combined (p < 0.05). The diameter of the ramus did not differ significantly among the three groups but was an average of $1.03{\pm}2.58mm$ wider in the men than in the women for all three groups combined (p < 0.05). In the skeletal class III malocclusion group, the ramus was longer than in the other groups and was an average of $7.9{\pm}3.66mm$ longer in the men than women. Conclusions: The location of the mandibular foramen was higher in the skeletal class III malocclusion group than in the other two groups, possibly because the ramus itself was longer in this group. This information should improve the success rate for inferior alveolar nerve anesthesia and decrease the complications that attend orthognathic surgery.

• The Korean Journal of Physiology and Pharmacology
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• v.4 no.6
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• pp.525-530
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• 2000

During reperfusion of skeletal muscle after ischemia, lipid mediators, mainly eicosanoids, are released and may have a role in the pathogenesis of reperfusion injury. To validate the role of eicosanoids in the ischemia-reperfusion induced functional deficits in skeletal muscle, we compared muscle edema and the changes of eicosanoid concentration in the rat hind limb after ischemia-reperfusion injury by application of tourniquet. After 4 hours of ischemia, reperfusion was established for 4 hours by releasing tourniquet. To assess tissue damage, edema, and wet/dry weight ratios were determined and the eicosanoid concnentrations were measured by the HPLC. The muscle edema and the release of cyclooxygenase metabolites were not induced by the ischemia itself rather they were significantly increased by reperfusion. Indomethacin treatment ameliorated limb edema and decreased the release of $6-keto-PGF_{1{\alpha}},$ thromboxane $B_2,$ and $PGE_2$ inducedby reperfusion. But the inhibitory effect of indomethacin on edema (35%) was relatively low than the inhibitory effect on release of cyclooxygenase metabolites (up to 69%) by reperfusion. These results support the view that cyclooxygenase products may play a significant role in the formation of muscle injury by ischemia-reperfusion and suggest that nonsteroidal antiinflammatory agents might be partially beneficial to the management of acute limb ischemia-reperfusion injury.

• Research in Plant Disease
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• v.22 no.3
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• pp.133-144
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• 2016

Powdery mildew (Podosphaera xanthii) causes severe damage to pumpkin crops grown in open fields and plastic house. Initially, we used ten accessions of pumpkin species; Cucurbita pepo (3), C. maxima (2), C. moschata (2), and C. argyrosperma (3) to study the disease progress in different stages of seedling development. Commercial pumpkin varieties were used as susceptible host for inoculum management and young seedlings were inoculated by dusting powdery mildew spores on the cotyledons, 1-true-leaf and 2-true-leaf seedling stages. Based on initial study, we further evaluated 218 pumpkinaccessions for their resistance to powdery mildew in different seedling stages under plastic house. Area under disease progress curve (AUDPC) and relative AUDPC (rAUDPC) was higher in cotyledonary and 1-true-leaf than 2-true-leaf stage. Seedlings at cotyledons and 1-true-leaf seedling stage displayed more susceptibility to powdery mildew. Based on evaluation of 2-true-leaf stage, IT 110859 and IT 278459 from C. pepo and C. argyrosperma identified as resistant (<0.2). Of the 228 pumpkin accessions, 21 (9.2%) pumpkin accessions consisting of C. pepo (2), C. maxima (5), C. moschata (13), and C. argyrosperma (1) exhibited intermediate resistance (<0.4) to powdery mildew and these accessions are useful to growers for its rational management.

• Archives of Plastic Surgery
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• v.47 no.2
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• pp.187-193
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• 2020

Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. During the postoperative period, the patient followed an intensive rehabilitation program and was monitored for functional performance over 5 years of follow-up. Our assessment demonstrated skin tropism and sufficient muscle power to act against strong resistance (M5) in the muscles previously affected by paralysis, as well as a good localization of stimuli in the median nerve region and an imperfect recovery of two-point discrimination (S3+). We propose a novel and efficient procedure to repair >10-cm peripheral nerve gap injuries related to upper limb trauma.